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Joint injections or aspirations (taking fluid out of a joint) are performed in an office or hospital setting, often with a cold spray or other local anesthesia. After the skin surface is thoroughly cleaned, the joint is entered with a needle attached to a syringe. At this point, either joint fluid can be obtained (aspirated) and used for appropriate laboratory testing or medications can be injected into the joint space. This technique also applies to injections into a bursa or tendon sheath to treat bursitis and tendonitis, respectively.
Commonly injected joints include the knee, shoulder, ankle, elbow, wrist, base of the thumb and small joints of the hands and feet. Hip joint injection may require the aid of an ultrasound or X-ray called fluoroscopy for guidance. Some small joints may also be more easily aspirated or injected with aid of ultrasound.
Source: American College of Rheumatology
Joint replacement surgery is typically recommended to patients who have tried non-surgical treatment but still have joint pain. While this is an extremely effective surgical treatment, total joint replacement should be considered as the last, rather than the first, treatment option for patients with advanced arthritis of the hip, knee or shoulder.
Modern joint replacement surgery involves removal of the worn cartilage from both sides of the joint, followed by resurfacing of the joint with a metal and plastic replacement implant that looks and functions much like your normal joint. Although nearly every joint in the body can be replaced, most replacement surgeries involve the hip or knee.
Over the last 30 years, improved surgical techniques and new implant materials have been developed, making total joint replacement one of the most reliable and durable procedures in any area of medicine.
Source: American College of Rheumatology